Brain, Vol. 126, No. 12, 2775-2776,
December 2003
© 2003 Guarantors of Brain
doi: 10.1093/brain/awg276
Book Review |
BIOPSYCHOSOCIAL APPROACHES IN NEUROREHABILITATION: ASSESSMENT AND MANAGEMENT OF NEUROPSYCHIATRIC, MOOD AND BEHAVIOURAL DISORDERS
Newcastle University/Northgate & Prudhoe NHS Trust, Hunters Moor Regional Neurorehabilitation Centre, Newcastle upon Tyne, UK
BIOPSYCHOSOCIAL APPROACHES IN NEUROREHABILITATION: ASSESSMENT AND MANAGEMENT OF NEUROPSYCHIATRIC, MOOD AND BEHAVIOURAL DISORDERS
Edited by W. Huw Williams and Jonathan J. Evans
2003. Basingstoke: Taylor & Francis Group
Price £59.95. ISBN 1-84169-945-4.
This is an excellent book which addresses a number of important issues in the management of neuropsychiatric, mood and behavioural disorders in the context of acquired brain injury. The literature on these subjects is difficult to access and often contained in specialist neuropsychological, neuropsychiatric and rehabilitation journals. Thus, it is a pleasure to see these topics in a single book. The editors have gathered together a range of national and international expertise. The chapters are relatively short and thus it is a book that can be read in manageable sections. The editors have ensured that the language is accessible and not too specialised as many of these topics can descend into obscurity.
The book is divided into five sections. The first section covers assessment of mental health issues in the context of brain injury. Each chapter provides guidance for specific areas. There is, for example, an excellent chapter on mild traumatic brain injury by Nathan Zasler and Michael Martelli and a fascinating chapter which addresses the question, ‘Does post-traumatic personality change represent an exacerbation of premorbid traits?’ This well argued chapter concludes that personality changes occurring as a result of traumatic brain injury are largely independent of premorbid personality structure.
The next section covers assessment and treatment of mood and anxiety disorders. There is a good general overview of depression after brain injury by Simon Fleminger and colleagues and an excellent resume of the role of cognitive behavioural therapy in the treatment of depression by Drs Khan-Bourne and Brown. The increasing usefulness of cognitive behavioural therapy in this context is also emphasised in the following chapter using CBT in anxiety disorders. Finally, Tom McMillan and colleagues have addressed the issue of post-traumatic stress disorder and traumatic brain injury and reviewed the causal mechanisms, assessment and treatment possibilities.
Section three covers various behavioural, health and habit disorders. Many individuals who suffer traumatic brain injury also have substance abuse problems or are prone to developing alcohol and substance abuse difficulties after the injury. This is a useful resume of the subject, particularly geared to the non-specialist in the addiction field. Stephen Tyrer and Amy Lievesley provide an excellent review of pain following traumatic brain injury and emphasise the frequent association of various painful conditions both immediately after injury and subsequently. The various treatment possibilities are discussed including analgesic drugs, graded exercise, cognitive behavioural therapy and transcutaneous electrical nerve stimulation. It is obviously well known that severe brain injury frequently leads to problems with anger and irritability and there are two chapters in the management of such problems, including the management of episodic dyscontrol syndrome by Peter Eames and Rodger Wood.
Lezak reminds clinicians that brain injury is a family affair and section four addresses issues regarding personal relationships. Michael Oddy and Camilla Herbert discuss interventions with families following brain injury and Jennie Ponsford provides a fascinating chapter on sexual changes.
The last section deals with issues of community integration, which is becoming increasingly important given modern pressures on hospital and rehabilitation unit beds. Finally, Tedd Judd provides an invaluable chapter on the rehabilitation of emotional problems in developing countries. This is a well-written and clear account of some of the problems of rehabilitation in the developing world and is a useful reminder that brain injuries are not confined to western culture. The ability to deal effectively with rehabilitation problems after brain injury in environments with virtually no resources are interestingly described in the context of the WHO model of Community Based Rehabilitation.
Frankly, it is difficult to fault this book. The chapters are well-written, clear, well-referenced and at the beginning there is a useful summary and most chapters end with a succinct conclusion.
All members of the neurological rehabilitation team will find it helpful but I would suggest it is particularly useful for clinicians who concentrate on physical rehabilitation after brain injury as a succinct source of reference for the neuropsychiatric, mood and behavioural disorders that are such common accompaniments after injury to the brain. The authors should be congratulated on an excellent textbook.
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